Trends in all-cause and cardiovascular disease mortality among women and men with and without diabetes mellitus in the Framingham Heart Study, 1950 to 2005
- PMID: 19307472
- PMCID: PMC2789419
- DOI: 10.1161/CIRCULATIONAHA.108.829176
Trends in all-cause and cardiovascular disease mortality among women and men with and without diabetes mellitus in the Framingham Heart Study, 1950 to 2005
Abstract
Background: Despite population declines in all-cause mortality, women with diabetes mellitus may have experienced an increase in mortality rates compared with men.
Methods and results: We examined change in all-cause, cardiovascular, and non-cardiovascular disease mortality rates among Framingham Heart Study participants who attended examinations during an "earlier" (1950 to 1975; n=930 deaths) and a "later" (1976 to 2001; n=773 deaths) time period. Diabetes mellitus was defined as casual glucose > or =200 mg/dL, fasting plasma glucose > or =126 mg/dL, or treatment. Among women, the hazard ratios (HRs) for all-cause mortality in the later versus the earlier time period were 0.59 (95% confidence interval, 0.50 to 0.70; P<0.0001) for those without diabetes mellitus and 0.48 (95% confidence interval, 0.32 to 0.71; P=0.002) for those with diabetes mellitus. Similar results were observed in men. Among women and men, the HR of cardiovascular disease mortality declined among those with and without diabetes mellitus. Non-cardiovascular disease mortality declined among women without diabetes mellitus (HR, 0.76; P=0.01), whereas no change was observed among women with diabetes mellitus or among men with or without diabetes mellitus. Individuals with versus those without diabetes mellitus were at increased risk of all-cause mortality in the earlier (HR, 2.44; P<0.0001) and later (HR, 1.95; P<0.0001) time periods.
Conclusions: Reductions in all-cause mortality among women and men with diabetes mellitus have occurred over time. However, mortality rates among individuals with diabetes mellitus remain approximately 2-fold higher compared with individuals without diabetes mellitus.
Figures
![Figure 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/2789419/bin/nihms126386f1a.gif)
![Figure 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/2789419/bin/nihms126386f1a.gif)
Similar articles
-
Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study.Cardiovasc Diabetol. 2019 Nov 16;18(1):157. doi: 10.1186/s12933-019-0953-7. Cardiovasc Diabetol. 2019. PMID: 31733656 Free PMC article.
-
Long-term all-cause and cardiovascular mortality following incident myocardial infarction in men and women with and without diabetes: Temporal trends from 1998 to 2009.Eur J Prev Cardiol. 2016 Aug;23(12):1273-81. doi: 10.1177/2047487316634279. Epub 2016 Feb 23. Eur J Prev Cardiol. 2016. PMID: 26907793
-
Association of sex-specific differences in lipoprotein(a) concentrations with cardiovascular mortality in individuals with type 2 diabetes mellitus.Cardiovasc Diabetol. 2021 Aug 18;20(1):168. doi: 10.1186/s12933-021-01363-x. Cardiovasc Diabetol. 2021. PMID: 34407812 Free PMC article.
-
Mortality in diabetes compared with previous cardiovascular disease: a gender-specific meta-analysis.Diabetes Metab. 2012 Nov;38(5):420-7. doi: 10.1016/j.diabet.2012.04.002. Epub 2012 Jun 7. Diabetes Metab. 2012. PMID: 22682738 Review.
-
Explaining the sex difference in coronary heart disease mortality among patients with type 2 diabetes mellitus: a meta-analysis.Arch Intern Med. 2002 Aug 12-26;162(15):1737-45. doi: 10.1001/archinte.162.15.1737. Arch Intern Med. 2002. PMID: 12153377 Review.
Cited by
-
Underlying mechanisms and cardioprotective effects of SGLT2i and GLP-1Ra: insights from cardiovascular magnetic resonance.Cardiovasc Diabetol. 2024 Mar 11;23(1):94. doi: 10.1186/s12933-024-02181-7. Cardiovasc Diabetol. 2024. PMID: 38468245 Free PMC article. Review.
-
Research progress on the association between glycemic variability index derived from CGM and cardiovascular disease complications.Acta Diabetol. 2024 Jun;61(6):679-692. doi: 10.1007/s00592-024-02241-0. Epub 2024 Mar 12. Acta Diabetol. 2024. PMID: 38467807 Review.
-
Empagliflozin Induces Vascular Relaxation in Rat Coronary Artery Due to Activation of BK Channels.Diabetes Metab Syndr Obes. 2024 Jan 20;17:247-257. doi: 10.2147/DMSO.S419125. eCollection 2024. Diabetes Metab Syndr Obes. 2024. PMID: 38269338 Free PMC article.
-
Association Between Body Mass Index and Clinical Outcomes According to Diabetes in Patients Who Underwent Percutaneous Coronary Intervention.Korean Circ J. 2023 Dec;53(12):843-854. doi: 10.4070/kcj.2023.0159. Epub 2023 Sep 20. Korean Circ J. 2023. PMID: 37973975 Free PMC article.
-
Abnormal left ventricular systolic reserve function detected by treadmill exercise stress echocardiography in asymptomatic type 2 diabetes.Front Cardiovasc Med. 2023 Oct 19;10:1253440. doi: 10.3389/fcvm.2023.1253440. eCollection 2023. Front Cardiovasc Med. 2023. PMID: 37928757 Free PMC article.
References
-
- Cooper R, Cutler J, svigne-Nickens P, Fortmann SP, Friedman L, Havlik R, Hogelin G, Marler J, McGovern P, Morosco G, Mosca L, Pearson T, Stamler J, Stryer D, Thom T. Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular disease prevention. Circulation. 2000;102:3137–3147. - PubMed
-
- Rosamond WD, Chambless LE, Folsom AR, Cooper LS, Conwill DE, Clegg L, Wang CH, Heiss G. Trends in the incidence of myocardial infarction and in mortality due to coronary heart disease, 1987 to 1994. N Engl J Med. 1998;339:861–867. - PubMed
-
- Fox CS, Coady S, Sorlie PD, Levy D, Meigs JB, D'Agostino RB, Sr, Wilson PW, Savage PJ. Trends in cardiovascular complications of diabetes. JAMA. 2004;292:2495–2499. - PubMed
-
- Gregg EW, Gu Q, Cheng YJ, Narayan KM, Cowie CC. Mortality trends in men and women with diabetes, 1971 to 2000. Ann Intern Med. 2007;147:149–155. - PubMed
-
- Gu K, Cowie CC, Harris MI. Diabetes and decline in heart disease mortality in US adults. JAMA. 1999;281:1291–1297. - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical